b'Ohio Auditor of State 2021 Annual ReportMedicaid Contract Audit Section (MCA) By the Medicaid Contract Audit Section (MCA) MCA is a standalonenumbersdepartment under the Audit Division. It employs 18 professionals who combat fraud, waste, and abuse, identify improper Medicaid219payments, and improve the integrity and cost-effectiveness of the Medicaid program. Number ofreports produced MCA participates in interagency Medicaid integrity groupsby MCA and is a member of the National Health Care Anti-Fraud Association $794,000MCA works with the Ohio Department of Medicaid (ODM)Medicaid to perform compliance examinations of Medicaid providerspaymentsand data-mining activities that identify risk areas for fraud, waste and abuse.$29,000Under an interagency agreement with ODM, MCA performsCosts incorrectly agreed-upon procedures on the cost reports submitted bycharged to intermediate-care facilities for individuals with intellectualMedicaiddisabilities and PASSPORT administrative agencies. Under a second interagency agreement with ODM, MCA tests incentive payments for implementing electronic health records in the Medicaid Promoting Interoperability Program (MPIP). During FY 2021, the AOS released a public interest audit of Ohios Medicaid Eligibility Determination Process testing 324 recipients from 27 different counties. The audit found that 4.9 percent of those recipients were in fact ineligible and identified a potential loss of over $455 million. The audit highlighted the confusing rules, system errors, human errors, and communication difficulties in the process and their impact on the accuracy of Medicaid eligibility determination.In March 2021, MCA initiated a public interest audit focused on Medicaid capitation payments made on behalf of beneficiaries after their date of death or during a period of incarceration. The audit is also testing for duplicate capitation payments and improper fee-for-service payments for services covered by managed care.EfficientlEffectivelTransparent13'